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Peer-reviewedCC BY 4.0Epidemiology and Psychiatric Sciences

Long-term suicide risk in lung cancer patients: a nationwide cohort study

  • Jung Eun Yoo1,2
  • Jin-Hyung Jung3
  • Kyung-Do Han4
  • Dong Woog Yoon5
  • Seonghye Kim6
  • Ji Hyun An7
  • Jong Ho Cho8
  • Dong Wook Shin6,9
9 affiliations
  1. 1Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
  2. 2Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  3. 3Health Insurance Review and Assessment Service, Wonju-si, Gangwon-do, Republic of Korea
  4. 4Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
  5. 5Department of Thoracic and Cardiovascular Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea
  6. 6Supportive Care Center, Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  7. 7Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  8. 8Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  9. 9Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Abstract

Aims: Lung cancer patients have a higher risk of suicide, but the long-term patterns and how they differ by treatment type have not been fully characterized. To investigate longitudinal suicide risk among lung cancer patients who underwent surgery compared to matched controls and to examine variations over time by treatment modality and patient characteristics.

Methods: We identified 37,215 individuals newly diagnosed with lung cancer between 2010 and 2017 who underwent lung resection within 1 year of diagnosis, along with 1:3 age- and sex-matched controls. Subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for suicide were estimated using a competing risk analysis.

Results: The cohort (mean age 64.0 years; 62.5% male) was followed for a mean of 7.6 years. There were 154 suicides among lung cancer patients (incidence rate 0.6 per 1,000 person-years). Suicide risk peaked during the first year after surgery (sHR 1.88, 95% CI 1.23–2.87) and declined in subsequent years. Patients who underwent surgery alone had a higher risk in the first year (sHR 1.66, 95% CI 1.02–2.69), which gradually decreased over time. In contrast, patients treated with adjuvant chemotherapy or radiotherapy experienced a substantially higher initial risk (e.g., sHR 7.00, 95% CI 3.00–16.37 for surgery + radiotherapy) and maintained a moderate increase in suicide risk even beyond 5 years. Subgroup analyses showed an especially elevated first-year suicide risk among younger adults aged 20–49 years, males, and never smokers.

Conclusions: Suicide risk for lung cancer patients is highest during the first postoperative year, particularly for those who receive multimodal therapy, or are younger adults, males, or never smokers. These findings emphasize the need to prioritize early, tailored psychosocial support in survivorship care to help mitigate long-term suicide risk.

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Cite

BibTeXRIS
BibTeX
@article{yoo2026longterm,
  title = {{Long-term suicide risk in lung cancer patients: a nationwide cohort study}},
  author = {Jung Eun Yoo and Jin-Hyung Jung and Kyung-Do Han and Dong Woog Yoon and Seonghye Kim and Ji Hyun An and Jong Ho Cho and Dong Wook Shin},
  journal = {Epidemiology and Psychiatric Sciences},
  year = {2026},
  month = aug,
  doi = {10.1017/s2045796026100870},
  url = {https://doi.org/10.1017/s2045796026100870},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Long-term suicide risk in lung cancer patients: a nationwide cohort study
AU  - Jung Eun Yoo
AU  - Jin-Hyung Jung
AU  - Kyung-Do Han
AU  - Dong Woog Yoon
AU  - Seonghye Kim
AU  - Ji Hyun An
AU  - Jong Ho Cho
AU  - Dong Wook Shin
PY  - 2026
DA  - 2026/08/11
JO  - Epidemiology and Psychiatric Sciences
DO  - 10.1017/s2045796026100870
UR  - https://doi.org/10.1017/s2045796026100870
AB  - Aims: Lung cancer patients have a higher risk of suicide, but the long-term patterns and how they differ by treatment type have not been fully characterized. To investigate longitudinal suicide risk among lung cancer patients who underwent surgery compared to matched controls and to examine variations over time by treatment modality and patient characteristics.  Methods: We identified 37,215 individuals newly diagnosed with lung cancer between 2010 and 2017 who underwent lung resection within 1 year of diagnosis, along with 1:3 age- and sex-matched controls. Subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) for suicide were estimated using a competing risk analysis.  Results: The cohort (mean age 64.0 years; 62.5% male) was followed for a mean of 7.6 years. There were 154 suicides among lung cancer patients (incidence rate 0.6 per 1,000 person-years). Suicide risk peaked during the first year after surgery (sHR 1.88, 95% CI 1.23–2.87) and declined in subsequent years. Patients who underwent surgery alone had a higher risk in the first year (sHR 1.66, 95% CI 1.02–2.69), which gradually decreased over time. In contrast, patients treated with adjuvant chemotherapy or radiotherapy experienced a substantially higher initial risk (e.g., sHR 7.00, 95% CI 3.00–16.37 for surgery + radiotherapy) and maintained a moderate increase in suicide risk even beyond 5 years. Subgroup analyses showed an especially elevated first-year suicide risk among younger adults aged 20–49 years, males, and never smokers.  Conclusions: Suicide risk for lung cancer patients is highest during the first postoperative year, particularly for those who receive multimodal therapy, or are younger adults, males, or never smokers. These findings emphasize the need to prioritize early, tailored psychosocial support in survivorship care to help mitigate long-term suicide risk.
SN  - 2045-7960
SN  - 2045-7979
ER  -